Styf: Bears played concussion by the book, but still put Cutler at risk

That was Lovie Smith, after Sunday night's game, explaining why Jay Cutler went back into the game after being violently hit by the Texans' Tim Dobbins.

It was clear Cutler had been hit hard. It's less clear why he wasn't removed from the game immediately and sent to the locker room.

He was sent to the locker room early for examination for a rib injury three weeks ago after getting body-slammed by Detroit's Ndamukong Suh on “Monday Night Football.”

This time, he stayed in the game until being removed at the half.

The Bears say they played it by the book, having the trainers examine Cutler during a challenge of the play he was hurt on. The NFL agreed.

But that doesn't help the fact that Cutler was put at a huge risk by re-entering the game and promptly running down the field, diving and taking a hard hit again.

In the science of concussions, there are few certainties. There's more we don't know than we know, especially about what causes long-term damage.

What we do know is that an injured brain, like Cutler had, is more susceptible to further injury.

The same thing happened in 2010, when Cutler remained in the game after his concussion against the Giants and was later removed at halftime. Much like Alex Smith, quarterback for this week's Bears opponent, who threw a touchdown pass after his injury before being removed.

What we don't know is what it could mean for Cutler, or Smith, long term.

People like to count concussions and think that means something.

The reality is, if the concerns are long-term memory loss and health issues, the count doesn't mean anything. Each player reacts differently.

Some players have multiple concussions in a career and remain healthy post-football. Others are never diagnosed with a concussion – only repeated sub-concussive hits – and they leave football without their facilities intact.

Doctors and scientists can't pinpoint what makes one player more susceptible. That's why so much money is pouring into research to find those answers. Because at this point, they aren't even close.

Chronic traumatic encephalopathy, the disease that is blamed for the suicides of former players such as Dave Duerson and Andre Waters, can't even be diagnosed before death. Over-simplified, it's protein buildup in the brain that can shut down brain activity in the area it covers.

There's no telling if Cutler or Smith are already affected. It's been found in football players as young as 18.

The one thing that can be done is reducing the risk.

Before Sunday night's game, the Bears hosted a panel discussion – along with military personnel – about concussions, treatment and knowing when it's time to take a step back and own up to being hurt.

Both groups encounter the same issues in the field and on the field.

Oddly enough, Cutler's coach and teammates ended up speaking about the same thing in the same room postgame.

“Jay's a tough guy,” Brandon Marshall said. “If he was hurting, he wouldn't let us know.”

And that is the biggest issue.

Most NFL contracts aren't guaranteed. And players are fearful if they take a play off, they could lose their jobs.

No player wants to be Jahvid Best, the 23-year-old Detroit Lions former first-round pick who is out of work and out of a paycheck after suffering multiple concussions. He can't get a doctor to clear him.

There is, however, a worse ending.

The family of late NFL player Shane Dronett told me as much early last year, when they found out what was left of Dronett's brain after he committed suicide in 2009 showed signs of CTE.

During his playing days, Dronett told his parents he was dizzy, hurt and had constant headaches. But instead of telling team personnel, he put his head down, popped some painkillers and went back into the game, time after time.

Cutler, who was unavailable to speak with the news media because of NFL concussion protocol and also canceled his Monday radio show, essentially did the same.

He isn't in danger of losing his job, but he played hurt.

The thing players need to realize is that this is far different than playing on a rolled ankle or separated shoulder.

Because this could lead to serious, long-term health issues.

Cutler, or any player who gets hit that hard in the head, should leave the game and get a full examination.

Doctors should be positive they are symptom-free. Then, they can think about football.

Too often with head injuries, players and teams think of football first.

And while attitudes have changed, judging by the way Lovie and his team were careful while dodging questions postgame and Monday, they haven't changed enough.